Articular surface defects include injuries as a result of sport related trauma, impact injury or a past injury persisting for prolonged time periods. The acute and repetitive impact and torsional joint loading that occurs, for example, during participation in sports can damage articular surfaces causing pain, joint dysfunction, and effusions. In some instances, this particular surface damage leads to progressive joint degeneration and osteoarthritis of the joint. In most instances, joints can repair damage that does not disrupt the articular surface if they are protected from additional injury. Mechanical disruption of articular cartilage stimulates chondrocyte synthetic activity, but it rarely results in repair of the injury. Disruption of subchondral bone stimulates chondral and bony repair, but it rarely restores an articular surface that duplicates the biologic and mechanical properties of normal articular cartilage. Articular surface defects are difficult to heal or regenerate spontaneously.
Wharton's jelly is a viscous gelatinous substance found in the umbilical cord of mammals (hereinafter referred to as ‘Native Wharton's Jelly’). Native Wharton's Jelly contains high amounts of host extracellular matrix (ECM) components (including chondroitin sulfate, collagen, hyaluronic acid (HA), proteoglycans, and stem cells. Native Wharton's Jelly may also include growth factors such as, for example, fibroblast growth factor (FGF), insulin-like growth factor I (IGF-I), transforming growth factor beta (TGF-beta), platelet-derived growth factor (PDGF) and epidermal growth factor (EGF). Native Wharton's Jelly also has a significant elasticity characteristic as well as binding of water molecules.
In particular surface defects, the approach in addressing this condition is one of “repair or regeneration”. “Repair” refers to healing of the injured tissue or replacement by cell proliferation and new ECM. “Regeneration” refers to formation of entirely new articular surface which is identical to the original tissue. Key growth factors which can chemotactically cause cell proliferation, deliver ECM and cellular differentiation to hyaline cartilage are introduced to aid repair or regeneration.
While Native Wharton's Jelly is contemplated to provide essential elements for both the repair and regeneration of articular surface cartilage, it is a viscous gelatin that is difficult to deliver into the body for repair and/or regeneration. Accordingly, there is a need to provide Native Wharton's Jelly that can be readily and reliably delivered to the injured region of a subject for repair and/or regeneration of the articular surface cartilage thereof.